title: Endothelial function in women with and without a history of glucose intolerance in pregnancy.
abstract: OBJECTIVE
  Gestational diabetes mellitus (GDM) and milder gestational impaired glucose tolerance (GIGT) identify women who are at risk of developing cardiovascular disease. Endothelial dysfunction, as indicated by impaired flow-mediated dilatation (FMD) on brachial artery ultrasound, is an early marker of vascular disease. Thus, we sought to evaluate endothelial function in women with and without recent glucose intolerance in pregnancy.
  
  
  METHODS
  One-hundred and seventeen women underwent oral glucose tolerance testing (OGTT) in pregnancy, enabling stratification into those with normal gestational glucose tolerance (n = 59) and those with GDM or GIGT (n = 58). 6 years postpartum, they underwent a repeat of OGTT and brachial artery FMD studies, enabling assessment of FMD and 4 secondary vascular measures: FMD after 60 seconds (FMD60), baseline arterial diameter, peak shear rate, and reactive hyperemia.
  
  
  RESULTS
  There were no differences between the normal gestational glucose tolerance and GDM/GIGT groups in FMD (mean 8.5 versus 9.3%, P = 0.61), FMD60 (4.1 versus 5.1%, P = 0.33), baseline diameter (3.4 versus 3.4 mm, P = 0.66), peak shear rate (262.6 versus 274.8 s(-1), P = 0.32), and reactive hyperemia (576.6 versus 496.7%, P = 0.07). After covariate adjustment, there were still no differences between the groups.
  
  
  CONCLUSIONS
  Despite their long-term cardiovascular risk, women with glucose intolerance in pregnancy do not display endothelial dysfunction 6 years postpartum.
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada.
authors.forename: Shireen
authors.initials: S
authors.lastname: Brewster
authors.forename: John
authors.initials: J
authors.lastname: Floras
authors.forename: Bernard
authors.initials: B
authors.lastname: Zinman
authors.forename: Ravi
authors.initials: R
authors.lastname: Retnakaran
mesh_terms: D000328:Adult; D001916:Brachial Artery / Q000503:physiopathology*; D016640:Diabetes, Gestational / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000502:physiology* / Q000503:physiopathology; D005260:Female; D018149:Glucose Intolerance / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D012307:Risk Factors